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Obstetrics & Gynecology 2002;99:506-509
© 2002 by The American College of Obstetricians and Gynecologists
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CASE REPORTS

Pyometria After Hemostatic Square Suture Technique

Mark Ochoa, MD, Alexander D. Allaire, MD, MSPH and Michael L. Stitely, MD

Uniformed Services Residency in Obstetrics and Gynecology; and the Department of Obstetrics and Gynecology, National Naval Medical Center, Bethesda, Maryland

Address reprint requests to: Michael L. Stitely, MD, National Naval Medical Center, Department of Obstetrics and Gynecology, 8901 Wisconsin Avenue, Bethesda, MD 20889; E-mail: stitely1{at}aol.com.

ABSTRACT

BACKGROUND: The square suture technique to achieve hemostasis for postpartum hemorrhage has been described in the medical literature. In a prior report of 23 cases, there were no complications from the technique.

CASE: A young woman with an gravida 1 para 0 with an uncomplicated prenatal course presented at 40 weeks’ estimated gestational age in active labor. Cesarean delivery was performed for arrest of dilatation and was complicated by postpartum hemorrhage unresponsive to medical therapy and uterine artery ligation. Several hemostatic square sutures were placed, obtaining hemostasis. The patient presented 4 weeks postpartum with pain and mucopurulent discharge. Pyometrium was discovered at the time of dilation and curettage.

CONCLUSION: Pyometrium may result from the use of hemostatic square suture technique for control of postpartum hemorrhage.




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